California Suppliers Fighting Back Against Deep Medicaid Cuts & 15-Month Clawback

SACREMENTO, Calif. (June 5, 2020)—California HME stakeholders achieved a measure of success last year in pushing back against a Medi-Cal proposal for Medicaid reimbursement rates based on 80% of non-rural Medicare rates, convincing the agency to use higher rural rates, instead. The new rates went into effect in April 2020 and will be applied retroactively to January 2019; Medi-Cal is anticipated to begin recoupments soon.
 
AAHomecare has joined the California Association of Medical Product Suppliers (CAMPS) in seeking to limit the retroactive cuts. In a letter to the CMS Regional Administrator, AAHomecare notes that the California State Plan Amendment (SPA) seeking the cuts was amended and changed in November 2019, and urges the agency to adjust the plan approval date to October 2019 to meet requirements that an SPA cannot go into effect sooner than the quarter it was submitted.
 
AAHomecare’s letter also notes the severe impacts that 15 months of retroactive recoupment will have on HME providers currently dealing with the COVID-19 crisis, as well as the resulting threat to patient access to HME during the public health emergency.
 
On top of these significant new cuts, California has taken an additional 10% off of Medicaid reimbursements across the board since 2011—and the new 80%-of-Medicare rates will still be subject to that reduction, as well. Given these steep cuts, California HME leaders are gearing up to advocate for eliminating this longstanding 10% cut, as well as fighting January 2019 retroactivity for the new reductions. 
 
Devin DeLozier with SuperCare Health lays out what California suppliers are facing in this 2-minute video call-to-action to contact key state legislators. AAHomecare’s payer relations team will continue to partner with CAMPS leaders to advocate for a more sustainable Medicaid rate structure in California. Please continue to monitor the CAMPS website for call-to-action information on how you can join these advocacy efforts.